Kenneth G Lucas, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

188726 Issued in NY

Practice address

179 River St
Oneonta, NY 13820-2239

Phone

(607) 433-3484

Fax

(607) 432-5790

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment NPD
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  NPD (past)
• Tidalhealth Primary Care, LLC

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1104453208
  NPD (past)
• Tidalhealth Specialty Care, LLC

  • Adult Mental Health Clinic/Center
  • Salisbury, MD
  • NPI 1962027094
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1093762098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 RIVER ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202239",
            "telephone_number": "607-433-3484",
            "fax_number": "607-432-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KENNETH",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NY",
            "license": "188726",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012617180002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niko Vinson Cadungog Lima, PT
• Lincare Inc.
• Karaline Elizabeth Little
• Linda Lofrumento, NP
• Norman Loucks
• Marie Elizabeth Lucas, PA-C
• Wibert Charles Lusk, O.D.
• Donald Francis Lynd Jr., D.D.S.
• Alex Madden
• Anna Maria Madej, PT

• Pediatrics Physician in Oneonta, NY
• Providers in Oneonta, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.